Hybrid apparatus for fluid supply for endoscopic irrigation and lens cleaning

ABSTRACT

A hybrid apparatus for delivery of fluid in connection with endoscopic irrigation and lens cleaning including a connector which is adaptable to a flexible or rigid container, a connector arranged at the end thereof and connected via a tubing supply to a fluid, air and or gas source and to an endoscope during a procedure.

CROSS-REFERENCE TO RELATED APPLICATION

This application claims priority to and the benefit of U.S. Provisional Patent Application Ser. No. 61/391,277, filed Oct. 8, 2010, entitled “Hybrid Apparatus for Fluid Supply for Endoscopic Irrigation and Lens Cleaning,” the disclosure of which is hereby incorporated by reference in its entirety.

BACKGROUND

Embodiments herein generally relate to endoscopic irrigation systems and procedures. More specifically, the embodiments relate to the supply of fluid in conjunction with an endoscope to enable both endoscopic lens cleaning and endoscopic lavage (irrigation) from a single fluid source.

The desire to visualize inside the “living” human body via a light guiding tube instrument dates back to the early 1800's. The next several decades yielded advancements in light guiding tube instruments with the first successful visualization of the inside of a living human stomach by Dr. Rudolph Kussmaul (Germany) in 1868, followed by continued advancements with flexible fiberscopes in the 1960's. Today, many structures once considered beyond the realm of diagnostic evaluation and therapeutic intervention can now be visualized and treated by the endoscopist. For example, without the use of an “open” surgical technique, the endoscopist can provide a diagnostic evaluation and therapeutic intervention of the esophagus, stomach, duodenum, small intestine, biliary and pancreatic system. The diagnosis and treatment of many gastrointestinal (GI) disorders such as foreign body removal, gallstone removal, polyp removal, tissue biopsy, structure dilatation, stent placement (for patency and drainage), bleeding and haemostasis, require visual inspection, access to the inner parts of the gastrointestinal tract, endoscopic lavage (irrigation) and lens cleaning.

Due to the lower morbidity and mortality associated with endoscopic procedures and the increased utility associated with “higher” risk patient populations, endoscopic diagnostic and therapeutic interventions, specifically a colonoscopy, is one of the most widely performed medical procedures in the United States. Tens of millions of colonoscopy procedures are performed annually and are expected to increase in the coming years, resulting in an exponential explosion in operating expenses to an already fragile medical system.

During a routine diagnostic colonoscopy or a more complicated treatment of acute lower gastrointestinal bleeding, it is not uncommon to encounter mucus secretions, stool, and or bleeding which limits the endoscopist's visualization and therapeutic capabilities. To maintain a clear operative field and also acceptable visualization, a typical endoscopic system (e.g., Fujinon, Olympus, or Pentax) provides a way of delivering sterile water at a high flow rate for endoscopic lavage (irrigation) and a way of delivering sterile water at a comparatively low flow rate for optical lens cleaning. To deliver the sterile water at the higher flow rate needed for endoscopic lavage, a mechanical peristaltic pump is typically used to deliver the sterile water from a vented fluid supply, while the sterile water for the lower flow rate lens cleaning function is supplied from a separate pressurized (non-vented) fluid supply.

Traditionally, since the lavage and lens cleaning functions utilize different mechanisms to deliver the sterile water, separate fluid supplies (1,000 ml and 500 ml respectively) are used. The fluid supplies can be reusable bottles that are re-sterilized once every 24 hours. Due to stringent infection control procedures, however, some facilities have decided to use separate disposable fluid systems for both the lavage (irrigation) and lens cleaning functions. While this practice addresses some of the infection control recommendations, the increased financial burden on medical facilities across the country continues to go unaddressed at the precipice of an exponential explosion in the annual number of procedures.

Thus, the need exists for the supply of fluid in conjunction with an endoscope to enable both endoscopic lens cleaning and endoscopic lavage (irrigation) from a single fluid source.

SUMMARY

A hybrid apparatus and methods for fluid supply for endoscopic irrigation and lens cleaning are described herein. In some embodiments, the hybrid apparatus includes a connector (also referred to herein as a “cap”) which is adaptable to a flexible or rigid container that defines a chamber configured to contain a fluid. The hybrid apparatus includes a first tube, defining a first lumen therethrough, a second tube, defining a second lumen therethrough, and a third tube, defining a third lumen therethrough. The first tube fluidically couples with the chamber of the fluid source and a gas source such as to provide a gas (e.g., atmospheric air, oxygen, CO₂, etc.) to the fluid chamber. The second tube includes a first end and a second end. The first end of the second tube is configured to couple to the endoscope in any suitable manner dictated by the endoscope. The second end of the second tube is received through a first opening in the connector and configured to be disposed within the fluid to transport the fluid from the fluid source to the endoscope for, for example, endoscopic lens cleaning. The third tube includes a first end and a second end. The first end of the third tube is configured to couple to the endoscope and/or a peristaltic pump in any suitable manner dictated by the endoscope and/or peristaltic pump. The second end of the third tube couples to the connector such that at least a portion of the second end is disposed within the fluid and is configured to transport the fluid from the fluid source to the endoscope for endoscopic lavage.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a partial cross-sectional schematic illustration of a common endoscopic system.

FIG. 2 is a cross-sectional side view of a hybrid apparatus, according to an embodiment.

FIG. 3 is a cross-sectional schematic illustration of a hybrid apparatus used in an endoscopic system, according to the embodiment of FIG. 2.

FIG. 4 is a cross-sectional side view of a hybrid apparatus, according to an embodiment.

FIG. 5 is a cross-sectional schematic illustration of the hybrid apparatus used in an endoscopic system, according to the embodiment of FIG. 4.

FIG. 6 is a perspective view of a portion of a hybrid apparatus, according to an embodiment.

FIG. 7 is a cross-sectional side view of a hybrid apparatus, according to an embodiment.

FIG. 8A is a perspective view of a hybrid apparatus, according to an embodiment.

FIG. 8B is a magnified cross-sectional view of a portion of the hybrid apparatus, according to the embodiment of FIG. 8A.

FIG. 9 is a flow chart illustrating a method of using a hybrid apparatus for fluid supply for endoscopic irrigation and lens cleaning.

DETAILED DESCRIPTION

A hybrid apparatus is disclosed that includes a connector adaptable to a flexible or rigid container that defines a chamber configured to contain a fluid. The hybrid apparatus includes a first tube, defining a first lumen therethrough, a second tube, defining a second lumen therethrough, and a third tube, defining a third lumen therethrough. The first tube fluidically couples with the chamber of the fluid source and a gas source to provide a gas (e.g., air, oxygen, CO₂, etc.) to the fluid chamber. The second tube includes a first end and a second end. The first end of the second tube is configured to couple to the endoscope in any suitable manner as appropriate for the particular endoscope. The second end of the second tube is received through a first opening in the connector and configured to be disposed within the fluid, to transport the fluid from the fluid source to the endoscope for endoscopic lens cleaning. The fluid can be any suitable liquid used for endoscopic lens cleaning and/or irrigation. The third tube includes a first end and a second end. The first end of the third tube is configured to couple to the endoscope and/or a peristaltic pump in any suitable manner appropriate for the particular endoscope and/or peristaltic pump. The second end of the third tube couples to the connector such that at least a portion of the second end is disposed within the fluid and is configured to transport the fluid from the fluid source to the endoscope for endoscopic lavage.

In some embodiments, the apparatus is configured to provide fluid from the fluid source in any suitable manner. For example, the second tube conveys the fluid to the endoscope during a first time period and the third tube conveys the fluid to the endoscope during a second time period. The first and second time period can be, for example, at least partially concurrent (i.e., occurring at the same time) or independent. Additionally, the second tube can include at least one valve configured to prevent the flow of fluid within the lumen of the second tube into the chamber of the fluid source. Similarly, the third tube can include at least one valve configured to prevent the flow of fluid from the endoscope and/or an irrigation site proximate to the endoscope into the chamber of the fluid source.

In some embodiments, a hybrid apparatus for delivery of a fluid in connection with endoscopic irrigation and lens cleaning includes a connector which is adaptable to a flexible or rigid container that defines a chamber configured to contain a fluid. The hybrid apparatus includes a first tube, defining a first lumen therethrough, a second tube, defining a second lumen therethrough, and a third tube, defining a third lumen therethrough. The first tube fluidically couples with the chamber of the fluid source and a gas source to provide a gas to the fluid chamber and increase the pressure within the fluid chamber. The second tube includes a first end and a second end. The first end of the second tube is configured to couple to the endoscope in any suitable manner for the particular endoscope. At least a portion of the second tube is configured to be disposed within the lumen defined by the first tube. The second end of the second tube is received through a first opening in the connector and configured to be disposed within the fluid. The second end can include a valve configured to prevent the flow of fluid within the lumen of the second tube into the chamber of the fluid source. The second tube is configured to convey the fluid in response to an increase of pressure in the chamber produced by the gas at a first flow rate and transport the fluid from the fluid source to the endoscope for endoscopic lens cleaning.

In some embodiments, the third tube includes a first end and a second end. The first end of the third tube is configured to couple to the endoscope and/or a peristaltic pump in any suitable manner for the particular endoscope and/or peristaltic pump. The second end of the third tube couples to the connector such that at least a portion of the second end is disposed within the fluid. The third tube is configured to convey the fluid in response to the increase of pressure in the chamber produced by the gas and/or a peristaltic pump and transport the fluid from the fluid source to the endoscope for endoscopic lavage.

In some embodiments, a method includes a fluid source being sealed by a cap and conveying a gas from a gas source into a chamber of the fluid source to increase the pressure within the chamber. The method further includes conveying a first volume of fluid out of the chamber in response to the increase of pressure. The first volume of fluid is conveyed at a first flow rate via a first tube to an endoscope for endoscopic lens cleaning. The method includes conveying a second volume of fluid out of the chamber. The second volume of fluid is conveyed at a second flow rate, substantially greater than the first flow rate, via a second tube to an endoscope for endoscopic irrigation. Furthermore, the gas is conveyed from the gas source into the chamber of the fluid source at a rate sufficient to offset a change in pressure produced by the conveyance of at least a portion of the first volume of fluid or the second volume of fluid. In some embodiments, the first volume of the fluid can be conveyed during a first time period and the second volume of the fluid can be conveyed during a second time period. The first and second time period can be, for example, at least partially concurrent (i.e., occurring at the same time) or independent.

FIG. 1 is an illustration of an example of a conventional endoscopic system. An endoscope 60 is connected to an endoscopic control unit 3 that supplies both the light from the light source 3 b and air from the air pump 3 a to the endoscope 60. Air travels from the air pump 3 a through a connector 5 to an air tube 3 c, pressurizing a fluid source 6 and forcing the fluid out of a lens cleaning tube 2 a at a low flow rate. When the pressure begins to drop in the fluid source 6, the endoscopic control unit 3 replenishes the diminished air supply. The endoscopist can choose to clean the lens (not illustrated) of an endoscope by fully depressing the control button 61 a when desired, thereby allowing fluid to flow to clean the lens. In some embodiments, a filter (not illustrated) is disposed at a location between the air pump 3 a and the endoscope 60 to prevent airborne infectious materials from passing into/through the endoscope.

As discussed above, a high flow rate is typically required for endoscopic lavage (irrigation) where the primary function is to keep the operative field clean from debris (e.g.,—stool, bleeding). This function is traditionally accomplished with the use of a peristaltic pump 4. Lavage tubing 4 c is inserted into the peristaltic pump head 4 a and fluid is expelled by depressing a footswitch (not shown) when fluid is required. To prevent a negative pressure from forming in the fluid source 1 and the lavage tubing 4 c, an air vent (not shown) is included in the cap 1 a of fluid source 1. This vent feature allows room air to flow into the fluid source 1, which equalizes the pressure and prevents negative pressure. If a negative pressure were to develop, the potential for infection is increased because infectious matter could flow back from the patient toward the fluid source 1. In some embodiments, a filter can be placed in fluid communication with the vent to prevent infectious material from entering the fluid source.

FIGS. 2 and 3 illustrate an embodiment of a hybrid apparatus 10 where the supply conduits for endoscopic lavage (irrigation) and lens cleaning are connected to and draw fluid from a single fluid source 16. The hybrid apparatus 10 includes a cap 16 a, an air supply tube 13 c, a lens cleaning tube 12 a, and a lavage tube 14 c, as shown in FIG. 2. The cap 16 a is configured to couple to a fluid source 16 (FIG. 3) in any suitable arrangement as dictated by the fluid source. For example, in some embodiments the cap 16 a can include a series of threads configured to mate with a series of threads on a receiving portion of the fluid source 16. In some embodiments, the cap 16 a includes a protrusion and/or series of protrusions to create a snap fit with a receiving portion of the fluid source 16. As shown in FIG. 2, the cap 16 a includes a membrane 16 b, a first opening 16 c, a second opening 16 d, and a third opening 16 e. The membrane 16 b engages the fluid source 16 to provide a fluid-tight seal and can be any suitable sealing mechanism. For example, the membrane can be an o-ring, flange, collar, and/or the like and can be formed of any suitable material.

The air supply tube 13 c includes a first end 13 d and a second end 13 e and defines a lumen therebetween. The air supply tube 13 c can provide an air supply from an air pump 13 a (FIG. 3) to the fluid source 16. More specifically, the first end 13 d of the air supply tube 13 c couples to an endoscopic control unit 13 via a connector 15, as shown in FIG. 3. The endoscopic control unit includes the air pump 13 a, a light source 13 b, and any other suitable mechanism for endoscopic procedures. The first end 13 d of the air supply tube 13 c can couple to the endoscopic control unit in any suitable manner as dictated by the control unit (i.e., the first end 13 d can be coupled to any suitable fitting configured to couple to a specific endoscopic control unit such as, for example, Fujinon, Olympus, or Pentax). In some embodiments, an air filter (not illustrated) can be disposed between the air pump 13 a and fluid source 16. In other embodiments, the air filter can be coupled directly to the air pump 13 a.

The second end 13 e of the air supply tube 13 c is configured to receive a fitting and/or connector 13 f. The fitting 13 f is configured to couple the second end 13 e of the air supply tube 13 c to the cap 16 a, as shown in FIG. 2. More specifically, the fitting 13 f can be inserted into the second end 13 e of the air supply tube and create a friction fit. Similarly, the fitting 13 f can be inserted into the first opening 16 c of the cap 16 a. A one-way check valve 13 g can be disposed in the fitting 13 f to prevent backflow into the air supply tube 13 c. In some embodiments, a second one-way check valve can be disposed within the fitting of the first end 13 d. In this manner, the air supply tube 13 c is configured to supply air to the fluid source 16 and prevent the back flow of air into the air supply tube 13 c. Therefore, in use, the pressure builds within fluid source 16, and a pressure differential between the fluid source and air supply tube 13 c can form. The pressure differential helps maintain a positive pressure in the fluid source 16 even when large volumes of fluid are removed from the fluid source 16 during high flow rate lavage (irrigation). Said another way, the valve 13 g can prevent a negative pressure from forming in the fluid source due to the time delay of air being delivered from the air pump 13 a through the air supply tube 13 c when a large volume of fluid is removed for lavage.

As described above, the air supply tube 13 c defines a lumen. The lumen of the air supply tube 13 c is configured to receive at least a portion of the lens cleaning tube 12 a, shown in FIG. 2. In this manner, the lumen defined by the air supply tube 13 c is sufficiently large to house the lens cleaning tube 12 a as well as provide the air to the fluid source 16. The lens cleaning tube 12 a is configured to exit the lumen defined by the air supply tube 13 c in any suitable air-tight manner, such as, for example, an aperture, fitting, collar, and/or the like. The lens cleaning tube 12 a includes a first end 12 b and a second end 12 c and defines a lumen therebetween. The lens cleaning tube 12 a is configured to transport the fluid from the fluid source 16 to the endoscope for endoscopic lens cleaning. Similar to the first end 13 d of the air supply tube 13 c, the first end 12 b of the lens cleaning tube 12 a couples to the endoscopic control unit 13 via the connector 15, as shown in FIG. 3.

A portion of the lens cleaning tube 12 a is configured to be disposed within the fluid source 16. More specifically, the second opening 16 d defined by the cap 16 a receives a portion of the lens cleaning tube 12 a. The second end 12 c of the lens cleaning tube 12 a is configured to be disposed within the fluid contained in the fluid source 16. Additionally, the second end 12 c includes a one-way check valve 12 d at the end disposed in the fluid of the fluid source 16. In this manner, the valve 12 d allows fluid to travel out of the fluid source 16 through the lens cleaning tube 12 a and prevents fluid from being sucked out of the lens cleaning tube 12 a if a negative pressure forms in the fluid supply when, for example, high fluid flow rate lavage (irrigation) is called for by the endoscopist.

The lavage tube 14 c includes a first end 14 e and a second end 14 f and defines a lumen therebetween. The lavage tube 14 c can transport the fluid from the fluid source 16 to the peristaltic pump 14. As shown in FIG. 3, a second lavage tube 14 b can be used to provide the fluid from the peristaltic pump to the endoscopic control unit 13, specifically endoscope 60. The first end 14 e of the lavage tube 14 c is configured to couple to the peristaltic pump 14 in any suitable manner as dictated by the specific peristaltic pump (i.e., a specific fitting, collar, or coupling). Furthermore, the first end 14 e of the lavage tube 14 c includes a one-way check valve configured to allow fluid to flow out of the fluid source 16 through the lavage tube 14 c and prevents any backflow of fluid from the peristaltic pump 14 from entering the lavage tube 14 c. The third opening 16 e (FIG. 2) defined by the cap 16 a is configured to receive a portion of the lavage tube 14 c. The second end 14 f of the lavage tube 14 c is disposed within the fluid contained in the fluid source 16. The second end 14 f of the lavage tube 14 c includes a weight 14 g configured to maintain the second end 14 f of the lavage tube 14 c in the fluid contained in the fluid source 16.

During operation, the valve 12 d of the lens cleaning tube 12 a and the valve 13 g of the air supply tube 13 c allow for multiple different pressures to be maintained in the system. For example, an endoscopist can depress a footswitch (not shown) to activate a flow of the fluid for endoscopic lavage and/or depress the control button 61 a to activate a flow of the fluid for endoscopic lens cleaning. As fluid is removed from the fluid source 16 either via the lens cleaning tube 12 a or via the lavage tube 14 c, the pressure in the fluid source 16 can drop to a second pressure, lower than the original pressure, which can be the same as the pressure in the air supply tube 13 c. Even though pressure in the fluid source 16 has changed, the valve 13 g is configured to maintain the pressure in the lens cleaning tube 12 a at substantially its original pressure. Thus, the lens cleaning function can be used since the original pressure is still present in tube 12 a. When the pressure is reduced in the fluid source 16 by use of either the optical viewing lens cleaning function, the high flow rate lavage (irrigation) function, or both functions simultaneously, the reduced pressure is compensated for by the air pump 13 a via the air supply tube 12 b. This combination of tubing and valves provides for the safe simultaneous use of endoscopic lavage (irrigation) and optical viewing lens cleaning from a single fluid source.

FIGS. 4 and 5 illustrate an embodiment of a hybrid apparatus 20 where the supply conduits for endoscopic lavage (irrigation) and lens cleaning are connected to and draw fluid from a single fluid source. The hybrid apparatus 20 includes a cap 26 a, an air supply tube 23 c, a lens cleaning tube 22 a, and a lavage tube 24 c, as shown in FIG. 4. The cap 26 a is configured to couple to a fluid source 26 (FIG. 5) in any suitable arrangement as dictated by the fluid source. For example, in some embodiments the cap 26 a can include a series of threads configured to mate with a series of threads on a receiving portion of the fluid source 26. In some embodiments, the cap 26 a includes a protrusion and/or series of protrusions to create a snap fit with a receiving portion of the fluid source 26. As shown in FIG. 4, the cap 26 a includes a membrane 26 b, a first opening 26 c, and a second opening 26 d. The membrane 26 b engages the fluid source to provide an air/fluid-tight seal and can be any suitable sealing mechanism, for example those described with respect to FIG. 2.

The air supply tube 23 c includes a first end 23 d and a second end 23 e and defines a lumen therebetween. The air supply tube 23 c can provide an air supply from an air pump 23 a (FIG. 5) to the fluid source 26. More specifically, the first end 23 d of the air supply tube 23 c couples to an endoscopic control unit 23 via a connector 25, as shown in FIG. 5. The first end 23 d of the air supply tube 23 c is similar in form and function to the first end 13 d of the air supply tube 13 c described with respect to FIGS. 2 and 3, and, therefore, is not described in detail herein. The air supply tube 23 c is configured to receive at least a portion of the lens cleaning tube 22 a, shown in FIG. 4. In this manner, the lumen defined by the air supply tube 23 c is sufficiently large to house the lens cleaning tube 22 a as well as provide the air to the fluid source 26. Similarly stated, the coaxial configuration creates an annular space in which the air can be delivered from the air pump 23 a to the fluid source 26. As discussed above, an air filter (not illustrated) can be disposed between the air pump 23 a and the fluid source 26. The lens cleaning tube 22 a is configured to exit the lumen defined by the air supply tube 23 c via an opening defined by the second end 23 e of the air supply tube 23 c. The second end 23 e of the air supply tube 23 c is configured to receive a fitting 26 f that defines a first opening 26 c. The fitting 26 f is, for example, unitarily formed with the cap 26 a and extends from a top surface of the cap 26 a. The fitting 26 f is configured to couple the second end 23 e of the air supply tube 23 c to the cap 26 a, as shown in FIG. 4. More specifically, the second end 23 e of the air supply tube 23 c can be inserted over the fitting 26 f and create a friction fit. The first opening 26 c defined by the fitting 26 f is configured to receive at least a portion of the lens cleaning tube 22 a therethrough. The fitting 26 f is configured such that the first opening 26 c is of a large enough diameter to receive the lens cleaning tube 22 a and allow sufficient air to enter and/or exit the fluid supply 16 (see FIG. 3) as an endoscopist may require.

In some embodiments, a one-way check valve can be disposed within the fitting of the first end 23 d. In this manner, the air supply tube 23 c is configured to supply air to the fluid source 26 and prevent the back flow of air. Therefore, in use, the pressure builds within fluid source 26, and a pressure differential between the fluid source and air supply tube 23 c can form. The pressure differential helps maintain a positive pressure in the fluid source 26 even when large volumes of fluid are removed from the fluid source 26 during high flow rate lavage (irrigation).

As described above, the lens cleaning tube 22 a is at least partially disposed within the lumen defined by the air supply tube 23 c. The lens cleaning tube 22 a includes a first end 22 b and a second end 22 c and defines a lumen therebetween. The lens cleaning tube 22 a is configured to transport the fluid from the fluid source 26 to the endoscope for endoscopic lens cleaning. Similar to the first end 23 d of the air supply tube 23 c, the first end 22 b of the lens cleaning tube 22 a couples to the endoscopic control unit 23 via the connector 25, as shown in FIG. 5. A portion of the lens cleaning tube 22 a is configured to pass through the first opening 26 c defined by the fitting 26 f and be disposed within the fluid source 26. The second end 22 c of the lens cleaning tube 22 a is similar in form and function to the second 12 c of the lens cleaning tube 12 a described with respect to FIGS. 2 and 3, and, therefore, is not described in detail herein.

The lavage tube 24 c includes a first end 24 e and a second end 24 f and defines a lumen therebetween. The lavage tube 24 c can transport the fluid from the fluid source 26 to the peristaltic pump 24. As shown in FIG. 5, a second lavage tube 24 b can be used to provide the fluid from the peristaltic pump to the endoscopic control unit 23. The first end 24 e of the lavage tube 24 c is configured to couple to the peristaltic pump 24 in any suitable manner as dictated by the specific peristaltic pump (i.e., a specific fitting, collar, or coupling). Furthermore, the first end 24 e of the lavage tube 24 c includes a one-way check valve configured to allow fluid to flow out of the fluid source 26 through the lavage tube 24 c and prevents any backflow of fluid from the peristaltic pump 24 from entering the lavage tube 24 c. The cap 26 a includes a fitting 26 g configured to receive at least a portion of the lavage tube 24 c. More specifically, the fitting 26 g is unitarily formed with the cap 26 a such that a portion of the fitting 26 g extends away from the top surface of the cap 26 a in a similar direction as that of the fitting 26 f. Conversely, a second portion of the fitting 26 g extends away from the top surface of the cap 26 a in a substantially opposite direction. Similarly stated, the fitting 26 g is configured to extend above and below the top surface of the cap 26 a and defines a second opening 26 d therebetween. The second end 24 f of the lavage tube 24 c is configured to be inserted over the fitting 26 g and create a friction fit.

A third lavage tube 24 d can be disposed within the fluid contained in the fluid source 26. A first end 24 h of the third lavage tube 24 d is configured to be inserted over the second portion of the fitting 26 g, thereby creating a friction fit. The second end 24 i of the lavage tube 24 d includes a weight 24 g configured to maintain the second end 24 f of the lavage tube 24 c in the fluid contained in the fluid source.

During operation, the valve 22 d of the lens cleaning tube 22 a and the air supply tube 23 c allow for multiple different pressures to be maintained in the system. For example, an endoscopist can depress a footswitch (not shown) to activate a flow of the fluid for endoscopic lavage and/or depress the control button 61 a to activate a flow of the fluid for endoscopic lens cleaning. As fluid is removed from the fluid source 26 either via the lens cleaning tube 22 a or via the lavage tube 24 c, the pressure in the fluid source 26 can drop to a second pressure, lower than the original pressure, which can be the same as the pressure in the air supply tube 23 c. Even though pressure in the fluid source 26 has changed, the air supply tube 23 c is configured to maintain the pressure in the lens cleaning tube 22 a at substantially its original pressure. Thus, the lens cleaning function can be used since the original pressure is still present in tube 22 a. When the pressure is reduced in the fluid source 26 by use of either the optical viewing lens cleaning function, the high flow rate lavage (irrigation) function, or both functions simultaneously, the reduced pressure is compensated for by the air pump 23 a via the air supply tube 22 b. This combination of tubing and valves provides for the simultaneous use of endoscopic lavage and optical viewing lens cleaning from a single fluid source.

As shown in FIG. 6, a fluid source 36 is in direct fluidic communication with the endoscope 60 via a tube 32 e, which houses both a lens cleaning tube 32 a and an air supply tube 33 c. In some embodiments, the tube 32 e is a multi-lumen tube. At one end, the tube 32 e terminates at a connector 35. The connector 35 is configured to be coupled to both the air and water connections from the endoscope 60 via the tube 33 c and 32 a respectively and is also connected to the endoscopic control unit 33. At the opposite end of the tube 32 e, the water supply tube 32 a passes through the second opening 36 d in a cap 36 a and extends down towards the bottom (or substantially close to the bottom) of the fluid source 36, while the air supply tube 33 c terminates at the first opening 36 c of the cap 36 a (or extends slightly past the cap 36 a) to supply air to the fluid source 36. The lavage tube 34 c can be separate from or attached to the tube 32 c and is connected to the peristaltic pump (not shown in FIG. 6). In some embodiments, the tubes 34 c and 32 e are a unitary construction multi-lumen tube. The lavage tube 34 c also passes through the cap 36 a and extends down towards the bottom (or substantially close to the bottom) of the fluid source 36.

In some endoscopic systems, an endoscope, a peristaltic pump, and/or an endoscopic control unit (including the air pump) can be in such an arrangement as to require the tubes in different configurations. For example as shown in FIG. 7, a hybrid apparatus 40 includes a cap 46 a, an air supply tube 43 c, a lens cleaning tube 42 a, and a lavage tube 44 c. Similar to the cap 16 a as described with respect to FIG. 2, the cap 46 a includes a first opening 46 c, a second opening 46 d, and a third opening 46 e configured to receive at least a portion of the air supply tube 43 c, the lens cleaning tube 42 a, and the lavage tube 44 c, respectively. The interactions of the cap 46 a, the fluid source (not shown in FIG. 7), and the supply conduits are substantially similar to the interactions of the cap, the fluid source, and the supply conduits of the hybrid apparatus 10 described with respect to FIG. 2, thus some of the features of the cap 46 a, the air supply tube 43 c, the lens cleaning tube 42 a, and the lavage tube 44 c are not described herein. In contrast to the hybrid apparatus 10 described with respect to FIG. 2, the air supply tube 43 c and the lens cleaning tube 42 a are not configured to be coaxial. Similarly stated, the arrangement of the endoscope, the peristaltic pump, and the endoscopic control unit can require the supply conduits to be in a non-coaxial configuration. In this manner, the lens cleaning tube 42 a is not disposed within any portion of the air supply tube 43 c. Therefore, the lens cleaning tube 42 a, the air supply tube 43 c, and the lavage tube 44 c can be independently configured and, as such, can include any suitable valve, fitting, collar, or connector for coupling to the receiving port of the respective device.

FIGS. 8A and 8B illustrate an embodiment of a hybrid apparatus 50 where the supply conduits for endoscopic lavage (irrigation) and lens cleaning are connected to and draw fluid from a single fluid source 58. The hybrid apparatus 50 includes an air supply tube 53 c, a lens cleaning tube 52 a, and a lavage tube 54 c. Portions of the air supply tube 53 c, the lens cleaning tube 52 a, and the lavage tube 54 c can be substantially similar to portions of the air supply tube 33 c, the lens cleaning tube 32 a, and the lavage tube 34 c. Thus, some features of the hybrid apparatus 50 will not be described in detail with reference to FIGS. 8A and 8B.

In some embodiments, the air supply tube 53 c and the lens cleaning tube 52 a can be at least partially disposed in a multi-lumen tube 52 e. At one end, the tube 52 e terminates at a connector 55. In some embodiments, the other end the multi-lumen tube 52 e splits, branching into the air supply tube 53 c and the lens cleaning tube 52 a. The hybrid apparatus 50 includes a fluid spike 57 that is configured to couple to the air supply tube 53 c, the lens cleaning tube 52 a, and the lavage tube 54 c. The fluid spike is configured to pierce a septum port 58 a included in a flexible fluid source 58. The fluid spike 57 can be formed of any suitable material capable of piercing the septum port 58 a. The fluid spike 57 can include a sealing member 57 a configured to engage the septum port 58 a and provide a fluid tight seal. In some embodiments, the fluid spike 57 can include a locking mechanism and/or protrusion capable of selectively engaging at least a portion of the septum port 58 a and/or fluid source 58 and securing the fluid spike 57 to the fluid source 58.

The air supply tube 53 c is configured to terminate at the fluid spike 57 and provide air to the fluid source 58, thereby regulating the pressure therein. The lens cleaning tube 52 a and the lavage tube 54 c are configured to extend through the fluid spike 57 and be disposed within the fluid contained in the fluid source 58. Although not shown, the hybrid apparatus 50 can include valves similar to those described above. In this manner, the hybrid apparatus 50 can function similarly to the hybrid apparatuses described herein. For example, the hybrid apparatus 50 can transport a portion of a fluid to the endoscope for endoscopic lens cleaning via the lens cleaning tube 52 a in response to an increase of pressure within the fluid supply 58. Similarly, the hybrid apparatus 50 can transport a portion of the fluid to the endoscope for endoscopic lavage via the lavage tube 54 c in response to a peristaltic pump (not shown).

FIG. 9 is a flow chart illustrating a method 100 of using a hybrid apparatus for fluid supply for endoscopic irrigation and lens cleaning. The method 100 can be implemented by any hybrid apparatus included in an endoscopic system, as described herein. The method 100 includes conveying a gas (e.g., atmospheric air, oxygen, CO₂, and/or the like) from a gas source to a chamber of a fluid source at 110. The fluid source can be any suitable fluid source described herein, such as, for example, a flexible or rigid container. The gas can be conveyed to the chamber of the fluid source in such a manner as to control (i.e., increase or maintain) the pressure within the chamber at 120. In some embodiments, the flow of the gas into the chamber is controlled by a valve included in an air supply tube, such as, for example, the air supply tube 13 c described with respect to FIG. 2. In other embodiments, an air pump can include the valve. In such embodiments, the air pump prevents the backflow of air from the chamber through the pump.

The method 100 further includes conveying a first volume of fluid out of the chamber via a first tube to an endoscope for endoscopic lens cleaning at 130. The first tube can be any suitable tube described herein, for example, the air tube 23 c described with respect to FIG. 4. In some embodiments, the first volume of fluid can be conveyed in response to the increase of pressure in the chamber of the fluid source. The first volume of fluid can be conveyed at a first flow rate suitable for endoscopic lens cleaning. In some embodiments, the first tube includes a valve. In this manner, the air supply tube can convey a gas to the chamber of the fluid source, thereby increasing the pressure such that the valve of the first tube opens to convey the first volume of fluid at the first flow rate.

The method 100 also includes conveying a second volume of fluid out of the chamber via a second tube to the endoscope for endoscopic irrigation at 140. Similar to the first tube, the second tube can be any suitable tube described herein. In some embodiments, the flow of the second volume can be in response to a peristaltic pump. In this manner, the peristaltic pump can convey the second volume of the fluid to the endoscope at a second flow rate. In some embodiments, the second flow rate is greater than the first flow rate of the first volume. The second flow rate can be any flow rate suitable for endoscopic lavage. Additionally, the gas source can convey the gas, via the air supply tube, in response to the change of pressure within the chamber of the fluid source produced by the flow of the first volume and/or the second volume.

In some embodiments, the first volume and the second volume can be conveyed in response to a manual control button included in the endoscopic system. In such embodiments, an endoscopist can depress a control button to initiate the flow of the first volume at a first time and depress a control button to initiate the flow of the second volume at a second time. The first time and the second time can be at substantially different times, the same time, or include any portion of concurrence. In some embodiments, the flow of the first volume and the second volume can be automatic. In such embodiments, an endoscope can provide a signal to an endoscopic control unit and/or peristaltic pump to convey the flow of the first volume and/or second volume.

The components of the hybrid apparatus can be packaged together or separately. For example, the cap and supply conduits can be in a package while an assortment of fittings, connectors, valves, and/or the like can be package separately. Each of the components discussed herein can be unitarily constructed or can be a combination of parts. For example, in reference to FIG. 4, the cap 26 a and fittings 26 f and 26 g are unitarily constructed. In some embodiments, the fittings 26 f and 26 g can be formed independently of the cap 26 a and be configured to couple to the cap 26 a (e.g., as threaded inserts and/or the like). Other aspects of the apparatus shown and described can be modified to affect the performance of the apparatus. For example, the valves described herein can be configured to provide a fluid and/or gas at a given volumetric flow rate for a given endoscopic device. In some embodiments, the volumetric flow rate can vary based on the setting required by the specific brand of endoscopic device (e.g., Fujinon, Olympus, or Pentax)

While various embodiments have been described above, it should be understood that they have been presented by way of example only, and not limitation. Where methods and/or schematics described above indicate certain events and/or flow patterns occurring in certain order, the ordering of certain events and/or flow patterns may be modified. Additionally certain events may be performed concurrently in parallel processes when possible, as well as performed sequentially. For example, while shown in the method 100 as being conveyed after the first volume, the second volume of fluid can be conveyed before the first volume or concurrently with the first volume. While various embodiments have been described as having particular features and/or combinations of components, other embodiments are possible having a combination of any features and/or components from any of embodiments as discussed above. 

1. An apparatus, comprising: a cap removably couplable to a fluid source, the fluid source defining a chamber configured to contain a fluid; a first tube coupled to the cap such that a lumen defined by the first tube is in fluid communication with the chamber of the fluid source when the cap is coupled to the fluid source, the first tube configured to fluidically couple a gas source to the chamber of the fluid source; a second tube configured to extended through a first opening in the cap such that, when the cap is coupled to the fluid source, at least a portion of the second tube is received in the chamber of the fluid source and an end of the second tube is disposed in the fluid therein, the second tube configured to convey fluid out of the chamber of the fluid source to an endoscope; and a third tube configured to extend through a second opening in the cap such that, when the cap is coupled to the fluid source, at least a portion of the third tube is received in the chamber of the fluid source and an end of the third tube is disposed in the fluid therein, the third tube configured to convey fluid out of the chamber of the fluid source to the endoscope.
 2. The apparatus of claim 1, wherein the second tube is configured to convey the fluid from the fluid source to the endoscope for endoscopic lens cleaning, and the third tube is configured to convey the fluid from the fluid source to the endoscope for endoscopic irrigation.
 3. The apparatus of claim 1, wherein the cap is ventless.
 4. The apparatus of claim 1, wherein the second tube is configured to convey the fluid from the fluid source to the endoscope during a first time period, the third tube is configured to convey the fluid from the fluid source to the endoscope during a second time period, at least a portion of the second time period is concurrent with at least a portion of the first time period.
 5. The apparatus of claim 1, further comprising: a valve coupled to the end of the second tube, the valve configured to prevent the flow of fluid from within the lumen of the second tube into the chamber of the fluid source.
 6. The apparatus of claim 1, further comprising: a valve coupled to the third tube, the valve configured to prevent the flow of fluid from at least one of the endoscope or an irrigation site proximate to the endoscope into the chamber of the fluid source.
 7. The apparatus of claim 1, wherein at least a portion of the second tube is disposed in the lumen of the first tube.
 8. The apparatus of claim 1, wherein at least a portion of the first tube and at least a portion of the second tube are coaxial.
 9. The apparatus of claim 1, wherein the first tube terminates outside of the chamber of the fluid source.
 10. A apparatus for delivering fluid to an endoscope, comprising: a cap assembly including a cap removably couplable to a fluid source, the cap assembly defining a first lumen configured to convey gas from a gas source into a chamber of the fluid source sufficient to increase a pressure within the chamber of the fluid source, a second lumen configured to convey a fluid out of the chamber of the fluid source responsive to the increased pressure within the chamber of the fluid source, and a third lumen configured to convey a fluid out of the chamber of the fluid source responsive to the increased pressure within the chamber of the fluid source; and a valve assembly including at least a first valve configured to prevent the flow of fluid from the second lumen of the cap assembly into the chamber of the fluid source.
 11. The apparatus of claim 10, wherein the second lumen is configured to convey the fluid from the fluid source at a first flow rate, the third lumen is configured to convey the fluid from the fluid source at a second flow rate greater than the first flow rate.
 12. The apparatus of claim 10, wherein fluid can be conveyed from the chamber of the fluid source through each of the second lumen and the third lumen substantially simultaneously.
 13. The apparatus of claim 10, wherein the second lumen is defined by a tube coupled through the cap, and the first valve is coupled to an end of the tube configured to be received in the chamber of the fluid source.
 14. The apparatus of claim 10, wherein at least a portion of the second lumen is disposed within at least a portion of the first lumen.
 15. The apparatus of claim 10, wherein the third lumen is configured to convey fluid out of the chamber of the fluid source responsive to a pumping force generated by a peristaltic pump.
 16. The apparatus of claim 10, wherein the cap is configured to seal the chamber of the fluid source from atmospheric air.
 17. The apparatus of claim 10, wherein the valve assembly includes a second valve configured to prevent the flow of fluid from at least one of the endoscope or an irrigation site proximate to the endoscope into the chamber of the fluid source.
 18. A method, comprising: conveying gas from a gas source into a chamber of a fluid source; conveying a first volume of fluid out of the chamber of the fluid source via a first tube coupled to a cap, the chamber of the fluid source being sealed by the cap, the first tube configured to convey fluid from the fluid source to an endoscope for cleaning of an endoscopic lens; and conveying a second volume of fluid out of the chamber of the fluid source via a second tube coupled to the cap, the second tube configured to convey fluid from the fluid source to the endoscope for endoscopic irrigation.
 19. The method of claim 18, wherein the conveying the gas into the chamber of the fluid source increases a pressure within the chamber of the fluid source, the first volume of fluid is conveyed from the fluid source via the first tube in response to the increased pressure within the chamber.
 20. The method of claim 18, wherein the gas is conveyed from the gas source into the chamber of the fluid source at a rate sufficient to offset a change in pressure within the chamber of the fluid source caused by the conveyance of at least one of the first volume of fluid or the second volume of fluid out of the chamber of the fluid source.
 21. The method of claim 18, wherein the first volume of fluid is conveyed at a first flow rate, the second volume of fluid is conveyed at a second flow rate greater than the first flow rate.
 22. The method of claim 18, wherein the first volume of fluid is conveyed during a first time period, the second volume of fluid is conveyed during a second time period, at least a portion of the second time period being concurrent with at least a portion of the first time period. 